Story by Patricia Beal on 07/26/2019The Womack Army Medical Center leadership team visited the Cape Fear Valley Medical Center pediatric ward on July 19 to celebrate a successful collaborative partnership in pediatrics.
The new legislative changes in the National Defense Authorization Act for Fiscal Year 2017 afforded opportunities to establish military-civilian integrated health systems. In the spring of 2018, Fort Bragg made the decision to move toward consolidating Womack's pediatric inpatient service with the Cape Fear Valley Medical Center due to a low beneficiary demand for pediatric inpatient service.
"As a retired naval officerand currently still working for the Navy at another facility, the camaraderie between Cape Fear and Army is something long overdue," said Dr. Abhik Biswas, medical director of inpatient pediatrics at Cape Fear Valley Medical Center.
Cape Fear Valley was able to assimilate the increased patient load without significant issue as a fair number of military children were already being admitted through the Cape Fear Valley Pediatric Emergency Department.
"The piece that wasn't addressed at the time was the skills maintenance for the pediatricians and family medicine physicians with regards to inpatient care of pediatric patients," Biswas said. "Since the consolidation, we at Cape Fear have worked with the Army to create an integrated inpatient team with the Womack physicians."
As in any profession, the more you do, the more reliable and effective you are in what you do. In December 2018, Womack signed an agreement for Army physicians to rotate at Cape Fear Valley. With access to more complex patient volume, this local military-civilian partnership sustains higher levels of Army physician readiness over longer periods of time.
The Womack physicians function as the inpatient ward attending while the CFV pediatric intensivists are the Pediatric Intensive Care Unit attending.
Womack physicians also provide teaching support for CFV's plethora of residents and students.
There are several Womack pediatricians and family medicine physicians who participate in seven-day rotations.
"It's our job to have someone here from 8 a.m. until 6 p.m. every day," said Army Captain Ann Schilling, M.D., medical director for both the newborn care unit and for inpatient pediatrics at WAMC. "I come here about once a month, sometimes once every six weeks or so, depending on who is on the schedule, and then the rest of the time I'm at Womack."
Having Army physicians at CFV helps military families in the coordination of follow-on outpatient care after hospital discharge.
"The Womack attendings are able to expertly navigate the TRICARE system for these families," Biswas said. "This ensures timely and appropriate post-hospitalization care."
Womack still provides pediatric services like cardiology, gastroenterology, endocrinology, adolescent medicine, developmental medicine, newborn nursery, newborn intensive care unit, and all the ancillary services like physical, speech, and occupational therapies.
Routine pediatric surgeries not requiring an overnight stay like tonsillectomies and adenoidectomies continue to take place at Womack.
"One place would be more convenient, but as long as we have a decent doctor, we'll go wherever we need to go," said Melinda Torrealba, whose daughter Eliana was born at Womack on May 7 and was being treated at Cape Fear Valley on June 13. "The nurses and doctors here have been amazing."
In a life-threatening emergency, TRICARE beneficiaries should proceed to the nearest emergency room. If safe to do so, they should go to the Womack Emergency Department.
"The Womack Army Medical Center Emergency Department is skilled and ready to care for patients of all ages, to include pediatric patients," said Dianne Bunch, the department's chief nurse. "We encourage our beneficiaries to present to the Womack Emergency Department for all care, and if a pediatric inpatient stay is necessary, we will arrange transport for them."